摘要
目的:观察引火汤对长期运用糖皮质激素治疗的类风湿性关节炎类风湿关节炎(RA)患者骨代谢的影响。方法:将长期接受激素疗法RA患者随机分为两组,对照组49例口服甲泼尼龙片、甲氨蝶呤片、碳酸钙D 3片;治疗组50例在对照组基础上联合中药汤剂引火汤口服。两组疗程均为6个月,比较两组治疗后骨代谢标志物(甲状旁腺激素、25-羟基维生素D 3)、L 2-4骨密度平均值(BMD)、血清钙磷水平、炎症指标(血沉、C反应蛋白)及关节VAS评分的变化。结果:两组治疗方案均可有效降低PTH水平(P<0.05),治疗组在降低甲状旁腺激素(PTH)及改善25-羟基维生素D 3、BMD方面优于对照组(P<0.05);在改善关节炎症与疼痛方面,治疗组优于对照组(P<0.05)。结论:引火汤可以改善RA患者长期口服抗风湿药物后的骨代谢及钙磷代谢平衡,与抗风湿药联用后可以增强抗炎作用,但目前研究尚不能证实其确切的机制。
Objective:To observe the effect of Yinhuo decoction on bone metabolism in patients with long-term glucocorticoid RA.Methods:Patients with long-term steroid therapy were randomly divided into two groups.The control group consisted of 49 patients taking oral methylprednisolone tablets,methotrexate tablets and calcium carbonate D 3 tablets.The treatment group consisted of 50 patients was combined with Yinhuo decoction on the basis of the control group.Soup was taken orally.Both groups were treated for 6 months.The bone metabolism markers(parathyroid hormone,25-hydroxyvitamin D3),L 2-4 bone mineral density(BMD),serum calcium and phosphorus levels,and inflammation index were compared between the two groups.ESR,C-reactive protein and changes in joint VAS scores.Results:Both groups were effective in reducing PTH(P<0.05).The treatment group was superior to the control group in reducing PTH and improving 25-hydroxyvitamin D 3 and BMD(P<0.05).In improving joint inflammation and pain.The treatment group was superior to the control group(P<0.05).Conclusion:Yinhuo decoction can improve the bone metabolism and calcium and phosphorus metabolism balance after long-term oral anti-rheumatic drugs in patients with RA.It can enhance the anti-inflammatory effect when combined with anti-rheumatic drugs,but the current research has not confirmed its exact mechanism.
作者
杨庆万
安阳
项飞燕
雷玉梅
YANG Qingwan;AN Yang;XIANG Feiyan(Guizhou University of Traditional Chinese Medicine,Guiyang 550025;不详)
出处
《陕西中医》
2020年第1期73-75,共3页
Shaanxi Journal of Traditional Chinese Medicine
基金
贵州省社会发展攻关项目(黔科合SY字[2015]3048)
贵州省高层次创新型人才培养计划—“百”层次人才项目(黔科合平台人才[2016]5650)
贵州省中医药(民族医药)治疗风湿病医学平台建设(黔科合平台人才[2018]5707)
